Objective To conduct a comprehensive scoping review on the risk factors of frailty in elderly surgical patients and to provide a reference for related research. Methods Taking the JBI scoping review guidelines as the methodological framework, the relevant literature on frailty in elderly surgical patients in both Chinese and English databases was systematically retrieved. The search time frame was from the establishment of the databases to December 18, 2024. Literature screening, data extraction and analysis were independently conducted by two researchers. Results A total of 13 articles were finally included. The incidence of frailty in elderly surgical patients ranged from 15.7% to 55.1%. A total of 4 frailty assessment tools were used in 13 articles. The risk factors for frailty included four aspects: demographic and sociological factors, physical health status, psychological and behavioral factors, and biomarkers. Conclusion Attention should be paid to the identification of frailty risk in elderly surgical patients. In the future, frailty risk assessment tools need to be improved and incorporated into routine nursing in the operating room to ensure surgical safety of elderly patients and promote postoperative recovery.